Proposal seeks certificate-of-need exemption for elective PCI at state hospitals after years of rule discussions
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Summary
House Bill 1755 would exempt state-owned hospitals from certificate-of-need requirements for elective percutaneous coronary intervention (PCI) services, a change proponents said would reduce delayed follow-up care for vulnerable patients at Harborview.
House Bill 1755 would create a limited certificate-of-need exemption for hospitals owned or operated by a state entity to provide percutaneous coronary interventions (PCI), the catheter procedures used to open blocked coronary arteries.
University of Washington clinicians and Harborview Medical Center supporters told the committee that a six-year effort to change Department of Health rules has not resolved a local access issue and that the bill would let Harborview perform elective PCI procedures without duplicative or protracted certificate-of-need requirements.
Dr. Michael Chen, an interventional cardiologist at Harborview, said some of the hospital's most vulnerable patients face transportation, language and behavioral-health barriers that make it difficult to complete multi-visit care. "When the procedure is done and indicates the need for stenting ... our patients have to wait, be taken off the table, and get another appointment at the University Hospital to essentially complete the procedure," Chen said. He said that delay has led to complications and that two patients had died while waiting for follow-up interventions.
UW and Harborview representatives asked the committee to act because rulemaking at the Department of Health, started in 2019 and continued through 2024, could take additional months before any permanent rule change takes effect, they said.
Providence and other health systems opposed the bill, telling lawmakers that the proposal creates a single-provider carve-out and would circumvent ongoing, multi-stakeholder rulemaking that aims to address access across the state. Teddy Maguire of Providence said rulemaking workshops, external work groups and stakeholder engagement were near conclusion and that a statutory carve-out would be unfair to other providers.
Representatives from St. Anne Hospital (Virginia Mason Franciscan Health) and other community hospitals described similar operational challenges: hospitals that can provide emergent PCI care for heart attacks argued they should be permitted to offer the planned or "elective" PCI care without a separate certificate-of-need barrier.
No formal vote was recorded. Committee members asked questions about payer mix, equity and ongoing rulemaking; several speakers said they would continue talks with the department and stakeholders.
Ending: Sponsors said they would continue discussions to reconcile equity concerns and the department's rulemaking progress; opponents urged completing the multi-stakeholder rule process rather than creating an exemption for a single provider.